The first report of Apiotrichum mycotoxinivorans isolation from human cerebrospinal fluid.

Fungal infections due to Apiotrichum mycotoxinivorans are clinically rare. Here, we report a case of invasive blood and cerebrospinal fluid infection by Apiotrichum mycotoxinivorans in a girl with B-cell acute lymphoblastic leukemia. This is the first report of the isolation of Apiotrichum mycotoxinivorans from human cerebrospinal fluid. MRI features of meningitis caused by this fungus are presented. Three small isoquinoline alkaloids inhibited the growth of this rare fungus in vitro, providing a starting point for the application of natural products to treat this highly fatal fungal infection. Our case presentation confirms Apiotrichum mycotoxinivorans as a potential emerging pathogen in patients with hematological malignancy undergoing chemotherapy.

Oral mycotic infection caused by a rare Verticillium species - a case report.

BACKGROUND: Deep-seated fungal infections of the oral cavity present a diagnostic challenge as the clinical presentation is usually aggressive leading to misdiagnosis of malignancy. Nevertheless, the species of fungi responsible for such diseases in immunocompromised individuals are varied thus, further complicating the diagnosis. CASE PRESENTATION: Presented below is a case regarding the diagnosis and management of deep mycotic infection of the oral cavity caused by a fungus that very rarely causes disease in humans, the Verticillium species. CONCLUSIONS: The case highlights the fact that rare pathogens should also be considered in the differential diagnosis, especially in patients with debilitating conditions like uncontrolled diabetes. Likewise, histopathological evaluation and microbiological investigations are of paramount importance and remain the gold standard to reach a definitive diagnosis.

Disseminated Hormographiella aspergillata Infection with Lung and Brain Involvement after Allogenic Hematopoietic Stem-Cell Transplantation in a 54-Year-Old Man.

Hormographiella is a rare fungal pathogen in humans; however, case reports have described disseminated infection in immunocompromised hosts. This pathogen has been described to yield poor prognosis in patients who harbor it. Herein, we present a case report of autopsy-proven disseminated Hormographiella aspergillata infection, confirmed by DNA sequencing, in a patient experiencing a relapse of leukemia. This 54-year-old Caucasian man with chronic myelogenous leukemia (CML) that had been diagnosed in 1989, after having received a hematopoietic cell allotransplant from a compatible sibling donor, had B-cell lymphoid-blast phase of CML in April of 2013, with multiple relapses. His most recent relapse was in September of 2016, when bone marrow biopsy showed 90% blasts. The results of bronchoalveolar lavage (BAL) cultures were positive for filamentous fungus infection. The patient developed encephalopathy and worsening respiratory statusand tachycardia with flutter and hypotension, which resulted in his death. At autopsy, bilateral pleural effusions, multiple right pleural nodules, and subarachnoid hemorrhage were noted. Angioinvasive hyphal fungi were found in the right frontal lobe of the brain and the right upper lobe of the lung. Morphologically, the fungi had multiseptate, branching hyphae. The bronchoalveolar lavage specimen grew a fungus for which the colony morphologic characteristics and microscopic features were compatible with a Hormographiella species. H. aspergillata from the bronchoalveolar lavage was further identified by sequencing the D2 hypervariable region of the large-subunit (LSU) ribosomal DNA gene and the full internal transcribed spacer (ITS) regions.

First Records of Rare Ascomycete Fungi, Acrostalagmus luteoalbus, Bartalinia robillardoides, and Collariella carteri from Freshwater Samples in Korea.

The distribution and occurrence of rare ascomycete fungi within freshwater samples in Korea was investigated. Three rare fungal strains, CNUFC-YR537-1, CNUFC-CNUP1-1, and CNUFC-NDR3-1, were isolated using serial dilution method. On the basis of their morphological characteristics and phylogenetic analysis of their internal transcribed spacer regions and 28S rDNA sequences, the three isolates were identified as Acrostalagmus luteoalbus, Bartalinia robillardoides, and Collariella carteri, respectively. To our knowledge, these are the first records of rare genera Acrostalagmus, Bartalinia, and Collariella from Korea, and the first reports of A. luteoalbus, B. robillardoides, and C. carteri from freshwater samples.

First Records of Rare Ascomycete Fungi, Acrostalagmus luteoalbus, Bartalinia robillardoides, and Collariella carteri from Freshwater Samples in Korea

The distribution and occurrence of rare ascomycete fungi within freshwater samples in Korea was investigated. Three rare fungal strains, CNUFC-YR537-1, CNUFC-CNUP1-1, and CNUFC-NDR3-1, were isolated using serial dilution method. On the basis of their morphological characteristics and phylogenetic analysis of their internal transcribed spacer regions and 28S rDNA sequences, the three isolates were identified as Acrostalagmus luteoalbus, Bartalinia robillardoides, and Collariella carteri, respectively. To our knowledge, these are the first records of rare genera Acrostalagmus, Bartalinia, and Collariella from Korea, and the first reports of A. luteoalbus, B. robillardoides, and C. carteri from freshwater samples.

Fluorescent staining for the rapid diagnosis of rare invasive fungal infections / 中华微生物学和免疫学杂志

Objective To evaluate the performance of an enhanced fluorescent staining for the rapid diagnosis of invasive mycosis, especially rare cases, considering the traditional culture method always leads to delays in clinical diagnosis for its time consuming. Methods Cases of invasive mycosis identified by fluorescent staining in our hospital from September, 2017 to September, 2018 were retrospectively analyzed. Three rare in-vasive infections were reported in this study. Clinical specimens were pretreated using standard procedures and then smeared on slides along with the enhanced fluorescent dye. Species of the pathogens were identified accord-ing to their morphology under fluorescent microscope. The traditional culture method was used as a standard method to identify the pathogenic species based on their colony morphology, followed by PCR and sequencing analysis for further confirmation. Results Three cases of invasive mycosis caused by rare pathogens of Talaro-myces marneffei, Mucorales and Prototheca were rapidly diagnosed with the fluorescent staining method. Sequen-cing results indicated the species were Talaromyces marneffei, Rhizopus arrhizus and Prototheca wickerhamii. Conclusions Fluorescent staining is a rapid, economic and direct method for the diagnosis of invasive mycosis. The morphology of fungi is clear and easy to identify after fluorescence staining, which could be used for indica-tive diagnosis of highly suspected invasive mycosis and serve as an important complement to the traditional cul-ture method, especially for the diagnosis of rare or uncultured fungal pathogens.